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Evidence Based

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These 11 Supplements Can Help Strike Hormonal Balance

Written by Dr. Michael Ruscio, DC on December 24, 2024

Written by Dr. Michael Ruscio, DC on December 24, 2024 — Reviewed by Kellie Blake

• Black cohosh|
• Inositol|
• Probiotics|
• Vitamin D|
• Omega-3 fatty acids|
• Chasteberry|
• Resveratrol|
• Hops|
• Fenugreek|
• Licorice|
• PAS|
• Lifestyle and Diet|

Hormonal imbalances can impact everything from mood and capacity to handle stress to fertility, menopause symptoms, and other physiological functions. This is true, not just of sex hormones, but of thyroid hormones, stress hormones, and metabolic hormones as well. These systems are all interconnected, so whether your goal is fertility, to minimize symptoms of menopause, or to balance female hormones more generally, taking measures to ensure that all of these systems are aligned is important.

For your body to function properly, your endocrine system needs to maintain healthy hormone levels. It’s important not to overlook the inputs that make this possible—lifestyle and diet, stress levels, environmental exposure, and more. Each of these factors is part of a holistic approach to balancing hormones. But for this article, I plan to do a deep dive into the supplements that can help support you as you begin to make behavioral shifts over time. No one expects you to change everything overnight so aiding the slow changes with supplements may help move things along more efficiently.

After focusing on how to balance your hormones with supplements and herbs, I’ll briefly touch on the bigger lifestyle and diet changes and share links to other key articles that discuss those shifts in more detail.

The 11 research-backed supplements and herbs we’ll cover today are listed in order of evidence quality.

1. Black Cohosh

Black cohosh is an herb native to North America that has been used traditionally for hundreds of years for women’s health. More recently, nearly 50 clinical studies support the use of black cohosh for balancing female hormones. Three large-scale looks at the available research in recent years have found that black cohosh may help relieve menopausal symptoms like mood swings and hot flashes 1 2. It can also improve hormone balance and pregnancy chances in women with polycystic ovary syndrome (PCOS) 3.

Dosage: The largest of the meta-analyses on this topic found that doses of 40–120 mg per day were most effective. Always check with your own doctor or healthcare provider before starting a new supplement or herb.

If you’re interested in trying it, Black Cohosh is a key ingredient in our Estro-Harmony product.

2. Inositol

Inositol is a type of sugar that helps your cells stay healthy. It’s naturally found in many foods, and can also be taken as a supplement. Holistic practitioners tend to recommend inositol to PCOS patients to help them balance their blood sugar by increasing insulin sensitivity. Two 2023 meta-analyses of 34 randomized controlled trials examined the efficacy of inositol as a dietary supplement for the treatment of PCOS.

PCOS symptoms may include difficulty losing weight, weight gain, inconsistent ovulation or irregular periods, high testosterone levels, and insulin resistance. Inositol was found to increase menstrual cycle regularity by 79% (which reduces infertility), improve BMI, and reduce testosterone levels. It also improved blood glucose and insulin levels 4. When compared to the conventional gold standard prescription medication, metformin, inositol was just as effective 4 5.

Dosage: Dosage is highly individual and should be determined by your healthcare provider. Randomized controlled trials used a range of 600–4,000 mg per day for 7–24 weeks.

3. Probiotics

Hormonal health is intricately tied to gut health. In our clinic, we’ve found that when women with PCOS, menopausal symptoms, or perimenopausal symptoms begin addressing gut health through a daily probiotic (along with other dietary improvements), we see positive hormonal shifts and symptom improvements.

Probiotic supplements may improve symptoms in the following ways:

• Improve hormonal and inflammatory markers for women with PCOS 6.
• Improve bone mineral density in postmenopausal women 7.
• Enhance sex drive and marital satisfaction in women with depression (when combined with SSRIs) 8.
• Reduce psychological and vasomotor symptoms (hot flashes/night sweats) during menopause 9.
• Decrease anxiety and stress (regulate nervous system) 10.
• Improve overall health, quality of life, and sense of well-being 10.

Additionally, probiotics can reduce gut inflammation and improve gut microbiome balance, which may influence estrogen metabolism 11. Using multiple strains, species, and categories seems to be the most effective way to improve gut biodiversity and overall health.

Dosage: We see fantastic results when our clients use our Triple Therapy Probiotic. Using a product like this ensures a comprehensive approach that includes all three categories in one supplement. If you’re particularly sensitive, you might start with half of a stick for a week or so before taking a full dose. Always talk to your doctor first before starting something new.

4. Vitamin D

Vitamin D is more than a vitamin—it’s also a hormone! So it may come as no surprise that it plays an important part in hormonal support. At higher doses (more than 4,000 IU/day for more than 8 weeks), vitamin D was shown to improve menstrual cycle regularity by 35% 12. Vitamin D may also help lessen period cramps, with a recent study showing that supplementing with a high dose the month prior to menstruation reduces pain and the need for pain medication 13. 

Vitamin D has been shown to improve testosterone levels, inflammation, and oxidative stress, and reduce luteinizing hormone in PCOS patients 12 14. People with PCOS patients tend to have higher testosterone levels than others, resulting in symptoms like male pattern baldness, acne, and more. Including vitamin D may help with hair loss as well, as a deficiency can lead to thinning.

Vitamin D may also play an important role in a balanced menopausal transition. Researchers have observed that vitamin D not only benefits bone health in menopausal women but also improves metabolism and glucose control 15.

Dosage: The range studied spanned 1,000–4,000 IU per day, however, researchers observed positive effects when dosing was higher than that for a prolonged period. Dosing is highly individual. In the clinic I usually recommend a conservative dose of 2,000–4,000 IU vitamin D3 per day.  If your blood levels are 100-124 nmol/L (40–50 ng/mL), you’re likely on the right track. It makes sense to get a baseline reading before supplementing so that you can track improvement over time. Although you should always check with your own provider, research suggests the following:

• An adult maintenance dose for supplementation is 2,000 IUs per day.
• An adult treatment dose (to correct deficiency) is 6,000 IUs per day. 

With regular testing, tweak your daily supplement intake up or down, depending on whether you’re under or over 100–125 nmol/L (40–50 ng/mL). I often recommend that my clients use vitamin D3 rather than D2, and combine it with vitamin K for maximum bone health benefit, especially for menopausal and postmenopausal women 16 17.

5. Omega-3 Fatty Acids

Omega-3s can significantly reduce the severity of premenstrual syndrome (PMS) symptoms, including both physical and psychological symptoms (cramping, bloating, mood changes), particularly with long-term use 18. 

Omega-3 supplements, especially when taken for more than 8 weeks, can also help women with PCOS by reducing waist size (but not weight loss), blood sugar levels, insulin resistance, and several cholesterol markers 19. 

Dosage: It seems that adding in omega-3s of any supplemental amount may be beneficial, but you’ll want to hone in on a specific dose with your medical practitioner. We offer a fish oil product that provides 1,280 mg per day.

6. Chasteberry (Vitex)

Chasteberry is a botanical medicine native to southern Europe and western Asia used traditionally to balance hormones. Chasteberry has been shown to reduce PMS-related breast pain as well as to normalize menstrual cycles and hormone levels in women with PCOS 20 21. It’s also been studied for its efficacy in reducing menopause-related anxiety and other symptoms of menopause when used for about three months 22.

Dosage: The typical dosage in the studies we examined ranged from 20-40 mg per day for 3 months 20. As always, run new supplements by your practitioner. Chasteberry is one of the key ingredients in Progest-Harmony.

7. Resveratrol

Resveratrol gained notoriety when it was found that red wine contains a good bit of it, leading to the idea that a glass of red a day keeps the doctor away. While we can’t confirm whether drinking red wine every day is a good or bad idea, key research findings show that resveratrol provides significant health benefits. 

Resveratrol, an antioxidant, is found in sweet potatoes, tangerines, walnuts, pistachios, and the skins of red and purple grapes. When taken as a supplement, it may help women with PCOS by improving prolactin levels, reducing acne, and lowering cholesterol 23. It may also reduce chronic pain from osteoarthritis and improve the quality of life for postmenopausal women 24. 

Dosage: The studies we looked at found benefits when patients used 800–1,500 mg per day for 40–90 days, but check with your doctor. Our shop offers resveratrol on its own at 500 mg daily. It’s also an ingredient in Estro-Harmony.

8. Hops (yes, that kind)

It might surprise you to learn that a main ingredient in beer making has been shown to benefit symptoms of menopause. But it’s true. This isn’t your doctor’s note to go buy a case of beer every week, however.

When taken as an extract in controlled dosing, and without the alcohol content and all the empty calories from beer, hops can effectively reduce menopausal symptoms like anxiety, depression, cramps, bloating, sexual dysfunction, and hot flashes in early menopausal women 25. In postmenopausal women, hops can be as effective as estradiol (synthetic estrogen) in improving sexual desire, arousal, and vaginal dryness 26.

Dosage: Hops may be taken as an oral extract or as a vaginal cream. Studies have seen effects at 100 mcg per day, when taken orally. Consult your healthcare provider to find the right dosing and vehicle for you.

9. Fenugreek

Fenugreek is an herb that’s similar to clover. The seeds are harvested for their medicinal and culinary benefits. When taken as a supplement, fenugreek can offer multiple benefits for women’s health.

For postmenopausal women, fenugreek can greatly increase estrogen levels and reduce hot flashes, with some women experiencing no hot flashes at all 27. For menstruating women, it can increase testosterone and estradiol levels, as well as boost sexual desire and arousal 28.

Dosage: The trials that demonstrated health benefits used 1,000 mg per day for postmenopausal women or 600 mg per day for menstruating women. Check with your doctor for a personalized recommendation

10. Licorice

Licorice root, which can be taken as a tea or supplement, showed similar results to those of hormone replacement therapy (HRT) for improving the frequency and duration of hot flashes, but HRT may reduce the severity of hot flashes more than licorice 29. An active ingredient in licorice, called glycyrrhizin, isn’t recommended for everyone. Talk to your doctor if you have a heart condition before starting a licorice supplement.

Dosage: The study we’ve referenced here used 1 g per day. Licorice is a main ingredient in Estro-Harmony and in Progest-Harmony. See dosage on label and check with your doctor before starting.

11. PAS (Lecithin Phosphatidylserine & Phosphatidic Acid Complex)

PAS is a supplement made from two types of phospholipids–phosphatidylserine and phosphatidic acid. Phospholipids are a special type of fat that is found in cells throughout your body, including your neurons (the cells of your brain and nervous system). PAS supplements are typically made from soybean or sunflower lecithin. 

PAS may safely improve PMS symptoms and has the potential to help treat premenstrual dysphoric disorder (PMDD), although more research in this area needs to be done. One study seems to show a lot of promise and compelling evidence 30. Randomizing 40 women with PMS, aged 18-45, some were given PAS or a placebo for three menstrual cycles.

Compared to the placebo group, the PAS group had:

• Reduced symptom severity 
• Improved physical and depressive symptoms
• Greater productivity
• Less relationship disturbance

Dosage: The small study used 400 mg phosphatidylserine and 400 mg phosphatidic acid per day for 3 menstrual cycles. Ask your doctor what might be right for you.

Lifestyle Factors to Improve Women’s Reproductive Health

As I promised at the start of this article, it’s imperative to mention the impact that lifestyle and diet have on hormonal health, especially female hormone production. Oftentimes, an unhealthy lifestyle and/or diet are a root cause of hormonal dysregulation. These factors affect gut health, which can often be obscured by other symptoms.

Having a balanced diet with plenty of high-quality proteins, healthy fats, vegetables, and unprocessed carbohydrates is a big first step in beginning to shift the hormonal landscape.

Managing stress (whether environmental or emotional) and having healthy coping strategies to take care of your mental health are also key factors. This is because the endocrine system ties all of your hormonal systems together. Chronic stress affects the adrenal glands, thyroid, cortisol production, and even your immune system. All of these systems need to be in order for your body to be able to master reproduction and produce the healthy hormones that make each stage of life go smoothly.

Sleep, exercise—especially resistance training—sun exposure, and meaningful relationships all play a role in maximizing your personal wellness, regulating abnormal hormonal fluctuations, and ensuring quality of life as you age.

The Bottom Line

Herbal supplements, as well as probiotics, vitamins, and a healthy lifestyle may be able to help naturally balance hormones. I don’t recommend starting all 11 of these at once, as that would be expensive, and likely overkill. It’s most effective to understand what each individual supplement or herb does for you before starting a new one. Each of the supplements we covered today is research-backed, but depending on your symptoms, it’s a good idea to start at the top of the list, where the most supportive research is available.

We would love to help you get started in balancing your hormones naturally. Reach out to our clinic to set up a consultation.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.